By Professor Taiwo Lateef Sheikh
Welcome to this week’s mental health conversation, this is a chat room where we discuss the basics of our mental health in order for us to understand and have a full grasp of the rudiments of mental health and well-being.
This is part of our mental health advocacy activities aimed at promoting our wholesome wellness, prevention of mental illness, improving our awareness of the mental illness, understanding that effective, qualitative and modern (technology-based) mental health services are available to ensure quality living, harmonious interpersonal relationships, peaceful coexistence within our communities and enhancement of our commonwealth. That we can discuss mental health in a major public forum like this and social media is a significant stride for global mental health and specifically, our local mental health advocacy! Especially considering the enormity of social, cultural and traditional barriers to such discussions.
A recap of our last conversation: We discussed “mental health distress (or mental health problem or mental health discomfort). A condition that is in between mental well-being and mental illness. This has set the stage for us to discuss mental health disorders and today we are discussing “depression and suicide”!
I will like to illustrate today’s conversation with the story of SG (hypothetical).
SG is a 35years old Bank worker (officer), he was recently promoted General Manager (GM) of the Bank and the future appeared set to be bright for him, he had all that it takes to become the Chief Executive of the Bank in the nearest future.
SG is the third among five children of his parents, Father is a successful businessman who sits on the board of two Commercial Banks, an Insurance company and a Manufacturing firm. Mother is a successful Lawyer (Senior Advocate of Nigeria)!
SG graduated from one of the topmost Universities in Nigeria with second class upper division in Economics at 20years of age, he proceeded to Harvard Business school and earned Masters in Business Administration (MBA) at 23 years of age. He joined the bank and rose to the position of GM within 12 years. He got married to his lovely wife at 28 years and both are blessed with three children.
Since leaving university, he has been known to be the busy type, had few friends but focused on his work. At 25years, SG realized he often doesn’t feel comfortable among his friends; he was losing the sense of companionship when spending time with them. He often gets lost in his thoughts when hanging out with friends, with his mind wondering randomly and sometimes feels strange.
He most often blame this on his schedules and believes that as he moves up the ladder at work, life will be less restrictive and he will enjoy more leisure, he was looking up to the time! SG sometimes complaint to his sister how dull life has become, she comforts and reassures him while encouraging him to get married. SG met his wife through his sister and they were married within one year after they met.
The wedding was a society wedding, everyone was happy, his parents were pleased and his siblings were not only proud of his choice but were very supportive. Everything was seemingly going on well for SG, a young man that any young man would like to be!! However, inwardly SG was not the happiest man though this inner feeling doesn’t manifest outwardly. He often feels quite unhappy but cannot understand why, he gradually and progressively was experiencing difficulty in bringing to his thoughts happy and exciting memories, rather he was most times preoccupied with unhappy events that happened earlier in his life; like the death (suspected suicide) of his paternal uncle who was alcoholic, he drove his car across a speeding train.
Six months after wedding, his wife (Mrs. SG) observed that her husband often gets moody, complaints of sadness that was difficult for him to explain and the mood change gradually became progressively pervasive.
The mood change was often accompanied by feeling tired or exhausted most of the times, loss of interest in pleasurable activities including (interest in her), lack of sexual drive and easily fatigued, poor appetite and lack of refreshing sleep.
Progressively, she observed that he lost interest in his dressings and appearance, he complained about his work and confided in her that he wanted to resign his work.
Five years into their marriage, about one year after the birth of their second baby, the complaints became intense, especially the preoccupation to resign, complaint of hopelessness, feeling of despair and expressing the belief of bleak future, the wife confided in his parents and were counseled to seek help of the Church. Special prayer sessions were organized with periods of fasting to free him from the spiritual attack.
After several sessions, his he felt much better and happier, interest in work was better and he was no longer contemplating resigning and, everyone was happy. Eighteen months later, the feeling of distress returned and this time with discomforting preoccupation with thoughts of death, his parents’ expectations.
Four weeks ago, the wife returned from work and found a suicide note on the dining table and his corpse hanging from the ceiling!
Depression is a mental health disorder characterized by persistently sad/depressed mood or loss of interest in pleasurable activities (including work) or loss of energy or a combination of any of these symptoms, causing significant impairment in daily life.
Depression is a common mental disorder affecting more than 264 million people worldwide and about eight million (4 percent) Nigerians (female 5 percent, male 3.6 percent) and suicide is a dreaded complication of depression.
To be concluded.
Possible causes include a complex interaction between biological, psychological and social factors (sources of distress). Increasingly, research suggests that these factors may lead to alteration in some chemicals (neurotransmitters) in the brain that can cause changes in brain function, including altered activity of certain neural circuits in the brain.
The persistent feeling of sadness or loss of interest that characterizes major depression can lead to a range of behavioral and physical symptoms. These may include changes in sleep, appetite, energy level, sexual drive, concentration, self confidence or self-esteem. Depression can also be associated with thoughts or planning of suicide. Depression is a leading cause of disability around the world and contributes greatly to the global burden of disease. The effects of depression can be long-lasting or recurrent and can dramatically affect a person’s ability to function and live a rewarding life.
Effective treatment for depression is available at the hospitals and in some states even at primary health care facilities including private clinics in Nigeria and, the mainstay of treatment is usually medication, talks therapy (psychological/psychotherapy), lifestyle adjustment (social) or a combination of the three (the combination has been shown to be more effective than using only one of them). Increasingly, research suggests that these treatments may normalize brain changes associated with depression and lead to recovery.
Access to effective treatment in this part of the world is significantly limited by lack of awareness, misconceptions and stigma.
I hope today’s conversation will add value to your understanding of depression and suicide, Depression can have a profound effect on all aspects of our lives, including performance at school, productivity at work, relationships with family and friends, and ability to participate in the community.
There are strong relationships between depression and physical health, including infections (such as tuberculosis, Covid-19), diabetes and cardiovascular disease (such as hypertension and heart disease). Depression affects all types of people, young and old, rich and poor in all countries. Women are more likely to have depression than men.
Professor Taiwo Lateef Sheikh
Next time we shall be discussing mental disorders.